MR. LEASEL WAYNE EVANS (NPI# 1275939043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275939043 |
| Entity Type | Individual |
| Full Name | MR. LEASEL WAYNE EVANS |
| Credential | RN, MSN, PMHNP-BC |
| Practice Address |
409 Nw 2nd Ave Canby OR 97013-3517 |
| Practice Telephone | 5032661407 |
| Practice Fax Number | 5032661849 |
| Mailing Telephone | 5032661407 |
| Mailing Fax Number | 5032661849 |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
201406240RN | OR | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201709151NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3415 Se Powell Blvd, Portland, OR 972023371 | 5032349591 |
| Street Address |
409 NW 2ND AVE |
| City | CANBY |
| State | OR |
| Zip Code | 97013-3517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467881813 | Peter C Sunderland | Registered Nurse | 409 Nw 2nd Ave, Canby, OR 97013-3517 | 2013-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639634314 | Clackamas County School District 86 | Local Education Agency (LEA) | 1130 S Ivy Street, Canby, OR 97013 | 2019-02-06 |
| 1669924502 | Brigid Marie-crotty Piccolotti | Speech-Language Pathologist | 344 N Holly St, Canby, OR 97013 | 2016-10-26 |
| 1497150247 | Speech With Sarah - LLC | Speech-Language Pathologist | 366 N. Holly St., Canby, OR 97013 | 2014-10-22 |
| 1164838116 | Annaliese Dianna Ellsworth | Social Worker | 550 Nw 3rd Ave Ste Bandc, Canby, OR 97013 | 2014-07-09 |
| 1639500804 | Alison Johnson | Social Worker | 11303 S Mulino Rd, Canby, OR 97013 | 2013-12-12 |
| 1184975260 | Tara Marie Mcgarry | Psychologist | 1433 Se 1st Ave, Canby, OR 97013 | 2012-09-28 |
| 1235488842 | Natalie Jackson Ballas | Dentist | 300 N Holly Street, Canby, OR 97013 | 2012-08-29 |
| 1699021667 | Canby Clinic | Naturopath | 452 Nw 1st Avenue, Canby, OR 97013 | 2012-07-27 |
| 1518231950 | Kyle Greer | Pharmacist | 1401 Se First, Canby, OR 97013 | 2012-03-02 |
| 1912284027 | Julie Michelle Francis | Counselor | 1655 S. Elm St #508, Canby, OR 97013 | 2011-11-03 |
| Find all providers in zip 97013 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831216779 | Robin Louis Perez | Nurse Practitioner | 409 Nw 2nd Ave Ste B, Canby, OR 97013-3517 | 2007-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1629687892 | Robin Sue Finney | Nurse Practitioner | 1957 Thompson Rd Ste I, Coos Bay, OR 97420-2040 | 2020-07-23 |
| 1518584457 | Akhena Health & Wellness LLC | Nurse Practitioner | 8855 Sw Holly Ln Ste 129, Wilsonville, OR 97070-8793 | 2020-06-26 |
| 1447871678 | Monarch Mental Health LLC | Nurse Practitioner | 1927 Channel St, North Bend, OR 97459-1826 | 2020-04-28 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1366071607 | Med Rx Partners, P.C. | Nurse Practitioner | 12115 Sw 70th Ave Ste 202, Tigard, OR 97223-9648 | 2020-04-08 |
| 1417583170 | Brittany Joy Monson | Nurse Practitioner | 12115 Sw 70th Ave, Tigard, OR 97223-9647 | 2020-03-13 |
| 1073147716 | Paradigm Mental Health and Wellness LLC | Nurse Practitioner | 724 S Central Ave Ste 101d, Medford, OR 97501-7808 | 2020-03-02 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.